Health & Science

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New guidelines for cholesterol drugs

The nation’s leading heart specialists have dramatically shifted their thinking on when doctors should prescribe cholesterol-lowering drugs. New guidelines from the American Heart Association and the American College of Cardiology abandon the use of a person’s cholesterol level as the main trigger for prescribing statins and, instead, focus on broader risk factors—an approach that could double the number of American candidates for the drugs to roughly 70 million. “The new guidelines will treat better and smarter, focusing on populations most likely to benefit,” University of North Carolina cardiologist Sidney Smith tells NPR.org. Following a four-year review of evidence, the research team concluded that statins would be most effective if used by people with high-risk factors for heart attacks and strokes, not to bring down levels of harmful cholesterol, known as LDL, to a specific target. Patients derive comfort from knowing they’ve hit that LDL target, doctors said, but the number is largely arbitrary. The real value of statins is that they reduce the buildup of waxy cholesterol in the arteries. “Statins treat risk, not only cholesterol,” said Neil Stone, a Northwestern University cardiologist who helped craft the new guidelines. Now, statins will be used to reduce the risk of stroke as well as heart disease. Some doctors, however, are already questioning the new guidelines, saying they overstate risk and will lead to unnecessary statin use.

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